Poland's syndrome with unusual hand and chest anomalies: A rare case report.

Poland’s syndrome is a rare congenital anomaly consisting of a unilateral absence of the pectoralis major, ipsilateral muscle, hand anomaly and occasionally associated other malformations of the chest wall and breast. Many structural and functional abnormalities have been described in association with this syndrome. We report an incidentally diagnosed case in a 27-year-old male patient who presented to us with symbrachydactyly. In addition to this, anterior depression of 2nd, 3rd and 4th ribs and bifid (forked) 5th rib was present on radiological investigations. The body of sternum was short and deformed on the right side with absence of xiphoid process. All middle phalanges were absent on right hand. It is a rare variant of Poland’s syndrome.

Assessment of nutritional status among adolescents: a hospital based cross sectional study.

Background: Adolescence, a period of transition between childhood and adulthood, occupies a crucial position in the life of human beings. The primary causes of under nutrition in India are its large population, socio-economic differences and inadequate access to health facilities. Nutritional assessments among adolescents are important as they are the future parents and constitute a potentially susceptible group. Studies on the assessment of nutritional status of adolescents are less in number and a National database has not yet been developed. Methods: The present hospital based cross sectional study was conducted in year 2013 among 344 rural adolescents of 10-19 years age (166 boys and 178 girls) attending the outpatient department at rural health training centre (RHTC) Dhaura Tanda, district Bareilly, Uttar Pradesh, belonging to the Muslim and Hindu caste communities. The nutritional status was assessed in terms of under nutrition (weight-for-age below 3rd percentile), stunting (Height-for-age below 3rd percentile) and thinness (BMI-for-age below 5th percentile). Diseases were accepted as such as diagnosed by pediatrician, skin specialist and medical officer. Results: The prevalence of underweight, stunting and thinness were found to be 32.8%, 19.5% and 26.7% respectively. The maximum prevalence of malnutrition was observed among early adolescents (28%-47%) and the most common morbidities were URTI (38.6%), diarrhea (16.8%), carbuncle / furuncle (16%) and scabies (9.30%). Conclusion: The study concluded that the most common morbidities among adolescents were related to nutrition and personal hygiene. Regular health programmes should focus to educate and promote health among adolescent.

Chemical and genetic diversity among some wild stands of Calligonum polygonoides (Polygonaceae) from the Thar Desert of Rajasthan

The arid Western Rajasthan, where the Thar Desert of India is immersed, is mostly covered by sand dunes, a common landscape. The region has confronted with fragilities of natural resources, low, erratic and ill-distributed rainfall, and is covered up with many perennial hardy shrubs. Calligonum polygonoides, the most common perennial shrub, is widely present in some localities of this Thar Desert. In this study, we evaluated the diversity present among 54 wild Calligonum polygonoides plants, sampled from eight different locations within the Thar Desert. Our methods included chemical/nutritional characteristics and random amplified polymorphic DNA (RAPD). Both chemical and molecular methods produced wider range of diversity, however, RAPD detected comparatively more diversity. A total of 163 band positions were produced by ten RAPD primers, of which 147 were found polymorphic with 90.18% polymorphism. RAPD-based Jaccard’s similarity coefficients ranged from 0.43-0.89. The analysis of various chemical and mineral constituents revealed that phog is an excellent source of calcium, potassium and phosphorous while relatively poor in zinc. Among minerals, average potassium content was found maximum (2 430mg/100g) with 0.14 CV. Zinc was observed comparably less in quantity while highest variable with CV 0.73. The chemical-based Manhattan dissimilarity coefficient values ranged from 0.01-0.22 with an average of 0.12. The comparison of the clusters obtained based on the chemical and mineral parameters with those of the RAPD data showed that the groups formed in both cases showed different patterns of relationships among the samples. Broader range of diversity might be due to the out breeding behavior of C. polygonoides and indicates the good adaptability of the plants in the region studied. However, low diversity observed in the Bikaner province is alarming and suggests that anthropogenic activities leading to heavy population disturbances can affect the genetic composition of the species in a considerable way.

El árido Rajastán occidental, en donde está inmerso el desierto de Thar en la India, está cubierto principalmente por dunas de arena, un paisaje común. La región ha enfrentado la fragilidad de los recursos naturales, las lluvias escasas, irregulares y mala distribución, y está cubierta con muchos arbustos resistentes perennes. Calligonum polygonoides, el arbusto perenne más común, se encuentra ampliamente en algunas localidades del desierto de Thar. En este estudio, se evaluó la diversidad presente entre 54 plantas silvestres de Calligonum polygonoides, de ocho localidades diferentes del desierto de Thar. Nuestros métodos incluyen características químicas/nutricionales y ADN polimórfico amplificado (RAPD) al azar. Ambos métodos químicos y moleculares producen un amplio rango de la diversidad, sin embargo, RAPD detectó comparativamente mayor diversidad. Un total de 163 posiciones de la banda fueron producidos por diez cebadores RAPD, de los cuales 147 se encontraron polimórficos con un 90.18% de polimorfismo. El coeficiente de RAPD basado en la similitud de Jaccard varió desde 0.43 hasta 0.89. El análisis de varios constituyentes químicos y minerales reveló que Calligonum polygonoides es una excelente fuente de calcio, potasio y fósforo mientras que es relativamente pobre en zinc. Entre los minerales, el contenido de potasio promedio se encontró como máximo (2 430mg/100g), con 0.14 CV. El zinc se observó comparativamente menor en cantidad, pero presentó la mayor variabilidad con CV 0.73. El valor del coefficente de disimilitud de Manhattan varió en un rango de 0.01 hasta 0.22 con un promedio de 0.12. La comparación de los grupos obtenidos según los parámetros químicos y minerales con las de los datos de RAPD mostró que los grupos formados en ambos casos mostraron patrones diferentes de relaciones entre las muestras. Una gama más amplia de la diversidad podría ser debido al comportamiento reproductivo C polygonoides e indica la buena adaptabilidad ...

Prevalence of Microalbuminuria and Proteinuria In Patients of HIV/AIDS in Jammu.

There is scarcity of Indian studies as far as the renal spectrum in HIV is concerned and there is no data regarding the detection of microalbuminuria and proteinuria in HIV positive patients in Jammu region. The present prospective study was conducted in the Postgraduate Department of Medicine, Government Medical College, Jammu over a period of 1 year on 108 HIV/AIDS patients, out of which 71% were males and 29% females with a male:female ratio of 2.48:1. Highest incidence of HIV/AIDS (55.56%) was found in the age group of 26-35 years. Microalbuminuria was present in 21% HIV patients with majority (60.87%) being in the age group 26-35 years. Prevalence of microalbuminuria among males was 65.22% and among females 34.78% with 83% patients having microalbuminuria/urinary creatinine ratio of >10 mg/mmol and 17% having this ratio <10 mg/mmol. There was a significant correlation between CD4 count <200/ l and presence of microalbuminuria (p = 0.01). Significant proteinuria (0.15- 3 g/24 hour) was found in only 3 of those patients found positive for microalbuminuria. No patients had protein/creatinine ratio >3.5 (nephrotic range). Nephropathy is an important cause of morbidity and mortality in HIV positive patients. Use of microalbuminuria as a routine screening test in those who are HIV positive is recommended. Simple tests, like microalbuminuria, if applied in these patients in the very screening phase can help benefit the patients for years to come thereby helping in fighting the epidemic of HIV/AIDS in a better and a stronger way.

Changing Attitude a paradigm shift in perception: Focus on Disability Studies.

Societal attitudes towards persons with disability have changed from time to time. Various factors contribute to these changing attitudes. The aim of the present study was to investigate the level of consciousness of different types of people towards disability. Study was conducted on a sample of 272 subjects consisting of, academicians 123, rehabilitation professionals-72 and administrator-77 using descriptive method. Disability Consciousness Questionnaire (DCSQ) developed by the author was administered to all subjects. It was revealed that gender, education, religion, occupation, income, nationality have a significant impact on the level of consciousness, but it is limited only to the parent’s perception. However, presence of disabled member in the family did not have any impact on the level of consciousness of the respondents.

Clinical evaluation of the mycobacteriophage-based assay in rapid detection of Mycobacterium tuberculosis in respiratory specimens.

CONTEXT: Search for a cost-effective, rapid and accurate test has renewed interest in mycobacteriophage as a tool in the diagnosis of tuberculosis (TB). There has been no reported data on the performance of phage assay in a high burden, low-resource setting like Kanpur city, India. AIMS: To assess the sensitivity and specificity of the FASTPlaque TB kit ability to impact the bacillary load in the phage assay and its performance in the sputum smear sample negative cases. MATERIALS AND METHODS: The study involved a cross-sectional blinded assessment of phage assay using the FASTPlaque TB kit on 68 suspected cases of pulmonary TB against sputum smear microscopy by Ziehl-Neilsen staining and culture by the LJ method. RESULTS: The sensitivity, specificity and positive and negative predictive values of the phage assay were 90.7, 96, 97.5 and 85.7%, respectively. The assay was negative in all the five specimens growing mycobacteria other than TB. The sensitivity of the phage assay tended to decrease with the bacillary load. Of the smear-negative cases, three were false negative, and all of which were detected by the phage assay. Smear microscopy (three smears per patient) had a sensitivity and specificity of 93 and 64%, respectively. CONCLUSIONS: The phage assay has the potential clinical utility as a simple means of rapid and accurate detection of live Mycobacterium tuberculosis bacilli; however, its performance has been inconsistent across various studies, which highlights that the assay requires a high degree of quality control demanding infrastructure and its performance is vulnerable to common adversities observed in "out of research" practice settings like storage, transport and cross-contamination.

Clinical Spectrum of Pulmonary and Extrapulmonary Tuberculosis in End Stage Renal Disease in Jammu.

One hundred patients of End Stage Renal Disease (ESRD) (mean age 50.5 years, S.D. 14.0341) during a period of one year from April 1, 2004 to March 31, 2005 were studied. Detailed clinical history, physical examination and laboratory investigations were recorded. Chi-square and Fischer-exact tests were used for statistical analysis. Sixteen cases of tuberculosis were detected in 100 ESRD patients. Fifteen of them were pulmonary and one extrapulmonary. Increased association of tuberculosis was seen in – diabetics as underlying cause for ESRD (37.5%), lower socioeconomic status (62%), male patients (68.75%), and patients > 35 years of age (87.5%). Anorexia was most common symptom (100%), followed by fever (87.5%) and cough (68.7%). Keeping in view of high incidence and prevalence of tuberculosis, patients of ESRD should always be screened for tuberculosis, requiring a high index of suspicion.

Chikungunya epidemic: global and Indian scenario.

Chikungunya is a disease of zoonotic importance affecting man with non-human primates as a main reservoir. Recently the world has seen its outbreaks in Asia and Africa affecting large population. The disease has re-emerged after 2 long decades. Other part of the world reported it as a disease which is introduced through travelers. The known vectors of Chikungunya are Aedes mosquitoes, notably Aedes aegypti and A. albopiticus. Although, the people of rural areas are among more risk groups, the disease spread very rapidly among urban population. The disease shows epidemic pattern with severe arthralgia and usually without any mortality but in the recent outbreak it has shown mortality also. Thus it is the major cause of public health concern. Understanding the public health significance of disease, there is a need of continuous monitoring and surveillance of the virus in both human and animal population.

Haemophilic Arthropathy

Bleeding into joints and soft tissues are the hallmark of haemophilia. The severity of manifestations co-relates with deficiency of the factor. The resorption of intra-articular blood induces reactive synovitis and causes cartilage damage, finally causing complete destruction of it. We hereby report a similar case and highlight various rheumatic manifestations of haemophilia and its management.

A comparative study of bronchodilator actions of ipratropium bromide (atrovent) & salbutamol (ventolin) on exercise induced bronchial asthma.

The bronchodilator actions of salbutamol and ipratropium bromide were compared in 30 established cases of bronchial asthma, before and after exercise. It was noticed that after exercise (brisk walk for 3 min.) the PFT values of FVC, PEFR and FEV-1, decreased remarkably from the basal values, the mean fall of 17.91%, 10.68% & 14.8% respectively was noticed. Salbutamol showed improvement in FVC, PEFR, FEV-1, of 20.86%, 15.96% & 17.98% respectively from basal values, while Ipratropium bromide showed improvement by 18.31%, 13.01% & 20.90% respectively. It was also noted that salbutamol is a better drug amongst smokers, patients with family history of bronchial asthma, and in younger age groups. Ipratropium bromide was better in elderly patients (> 40 yrs.) and in those with eosinophillia.

Saddle embolism of aorta.

Aortic saddle embolus is a rare but serious form of arterial embolisation in patients with myocardial infarction. Four patients with aortic saddle embolism with peripheral propagation of the clott are reported. Two patients had suffered an attack of acute anterior myocardial infarction (one and four weeks respectively) prior to the embolic episode. One patient had a transmural myocardial infarct five years ago, and the 4th patient had dilated cardiomyopathy. The onset was sudden, marked by pain, parasthesias, pallor, pulselessness in three patients, and gradual in one. Two of the three patients (both females) in whom clott migration occured in only one limb developed below-knee gangrene of the affected side. In one patient (a young male) clott migration occurred in both popliteal arteries and the limbs were spared from developing gangrene although he continues to have leg angina. One patient presented with intermittent calf claudication only. All our patients reported late due to which none could be subjected to embolectomy.

Candidal oesophagitis in Cushing's syndrome.

Opportunistic infections are known to occur with increased frequency in patients with Cushing's syndrome, particularly those due to ectopic ACTH production. This report highlights the rare situation of a patient with Cushing's disease having candidal oesophagitis as one of the major presenting manifestations.

Role of fine needle aspiration cytology in the diagnosis of tubercular lymphadenitis.

The need for a rapid diagnosis of the cervical lymphnodes presenting to the surgeon in the out patient department resulted in this study. A total of 123 cases were studied to evaluate Fine Needle Aspiration Cytology as a diagnostic procedure and a diagnostic accuracy of 89.77 per cent was achieved in tubercular lymphnodes. FNAC along with Mantoux test and Erythrocytic sedimentation rate (ESR) gave an over all diagnostic accuracy of 97.72 per cent. Thus the role of FNAC as a safe, quick and reliable procedure in the diagnosis of tubercular lymphadenitis was established.